ENDOSCOPIC DIAGNOSIS AND TREATMENTS FOR FAMILIAL ADENOMATOUS POLYPOSIS

Abstract

Opportunities for diagnosis of familial adenomatous polyposis (FAP) have increased with widespread use of colonoscopy, at the occasions of screening for colorectal cancer including fecal occult blood test or complete medical checkup using colonoscopy. In this paper, we describe the important points in the diagnosis of FAP that endoscopists should keep in mind, and introduce the latest studies on treatment of FAP.

FAP is an autosomal dominant inherited disorder whose main characteristic is multiple polyposis that develops in the large intestine. We describe particularly important points for the diagnosis of gastric adenoma, gastric cancer, fundic gland polyp, duodenal adenoma, colorectal adenoma, colorectal cancer, and adenoma that develops from the ileal pouch, all of which are observed among FAP patients at high frequency.

Previously, total colectomy and pancreaticoduodenectomy were the only treatment options for FAP. However, recently, endoscopic polypectomy is frequently performed for the treatment of FAP, and studies on chemoprevention therapy to suppress colorectal polyps are being conducted. We present the current status of our studies.

For additional information on the treatment of FAP, the “JSCCR 2016 Guidelines for the Treatment of Hereditary Colorectal Cancer” published by the Japanese Society for Cancer of the Colon and Rectum (JSCCR) can also be consulted.